Polycystic Ovarian Syndrome in Adolescent Chapter

Polycystic Ovarian Syndrome in Adolescents: Management of PCOS in Adolescents

The recent increase in the incidence of Polycystic Ovarian Syndrome (PCOS) in adolescents is becoming a major concern in America. PCOS is recognized as the most common endocrine disorder in adolescent women and it has both metabolic and reproductive consequences. It may manifest itself as early as the first decade in the individual's life. First described by Stein and Leventhal in 1935, PCOS occurs when small cysts surround the ovary due to hormonal imbalances. It is characterized by excessive androgenizations, which are high levels of male hormones, irregular menstrual cycles, and obesity. The disorder affects almost 5 to 10% of adolescent populations and is becoming a great concern because it is the most frequent cause of fertility in women. Due to the high prevalence of PCOS in adolescents, there has been increased research aimed at identifying the main cause of the disease. Nidhi and his team of researchers (2013) set out to find out how one specific hormone, the anti-mullerian hormone, contributes to the etiology of PCOS, and its recent emergence as a screening and diagnostic tool. This text takes a look at AMH in detail and investigates how holistic yoga programs can be used to control this hormone and other endocrine parameters.

The problem

Although PCOS is most common among adolescents, there is still a great debate about its pathogenesis and definition. The symptoms often vary with height, weight, race, age and medication and they pose great challenge when it comes to diagnosis. Furthermore, the normal characteristics of common puberty often overlap with the signs and symptoms - and diagnosis becomes rather complicated. In addition to menstrual irregularities and androgen excesses, other common features include excessive growth of hair on the arms and face, acne, alopecia, and skin problems.

According to Nidhi and his colleagues (2013), recent studies have pointed towards the excessive production of one particular hormone: the anti-mullerian hormone (AMH), which has been identified as one of the major causes of PCOS. AMH facilitates the accumulation of small follicles in the ovary and it may cause failed ovulation. Therefore, it is important to identify lifestyle changes such as methods of exercise, which will help in the reduction of AMH levels in adolescents.

Significance of the problem

Since the symptoms of PCOS can be distressing for adolescent and their families, it is imperative to find a solution that reduces the level of discomfort. Nidhi and his colleagues (2013) state that a stressful lifestyle can contribute largely to this distress, particularly because the chronic stimulation of sympathetic activity can cause a malfunction in the hypothalamus-pituitary-ovarian axis (HPO) in adolescents with PCOS. This highlights the need for strategies to reduce the level of stress, which will correct the HPO axis and reduce the sympathetic activities. Since yoga has been widely accepted as a holistic medicine of both the body and the mind, it may offer relief to adolescents with PCOS and help them reduce the level of discomfort and stress in their lives.

Participants

The participants in the study were adolescent girls aged between 15 and 18 years. The participants had to possess two thirds of the features of the Rotterdam criteria for PCOS which included: a lack of menstruation for more than 45 days, polycystic ovaries, and clinical hyperandrogenism. Those who had used oral contraceptives in the past 6 weeks, had previous experienced with yoga, smoked, had thyroid abnormalities, and were unwilling to participate were excluded from the study.

Methodology

After obtaining signed consent forms from parents, the adolescents first…